Utility of original and simplified pulmonary embolism severity indices in risk stratification of patients with pulmonary embolism: a study from Saudi Arabia

Abstract

Background We aimed to report our experience using both the pulmonary embolism severity index (PESI) and its simplified form (s-PESI) score in evaluating patients with PE admitted at a large Saudi Arabian Hospital. Patients and methods This was a retrospective analysis where the adult (≥14 years old) patients admitted to the hospital of the Armed Forces Hospital Southern Region with the diagnosis of acute PE through 1 year were enrolled. The accuracy of both PESI and s-PESI was evaluated for mortality. Results Two hundred and twelve patients were enrolled. We encountered a significant relation only with the 90, 180 days, 1 year, and overall in-hospital mortality for low versus high-risk classification by the s-PESI score. There was neither a significant correlation between any-period mortality and classes of PESI score nor between low versus high-risk s-PESI score and 30-day mortality. The sensitivity of PESI and s-PESI in predicting mortality were 66.7 and 97.0%, respectively. The area under the curve of PESI and s-PESI were 0.611 (P=0.043), and 0.629 (P=0.005), respectively. Conclusion Besides being an easier tool for stratifying the risk of patients with PE, our data show that the s-PESI score is utilizable in Saudi Arabian patients with PE admitted at a large tertiary hospital. s-PESI and PESI have good potential to predict the prognosis of PE in terms of in-hospital mortality, with higher sensitivity, negative predictive value, and area under the curve for s-PESI versus PESI. There was a significant correlation between the s-PESI and the 90, 180 days, 1 year, and the overall in-hospital mortality. Further prospective multicenter studies are needed.

Keywords

• index; mortality; predictive; pulmonary embolism; saudi arabia; severity; simplified; utility